Real-world study shows sustained effect of suprachoroidal triamcinolone in UME
Click Here to Manage Email Alerts
PARK CITY, Utah — Suprachoroidal drug delivery for uveitic macular edema provides durable effects in real-world settings, matching those of phase 3 clinical trials, according to a speaker at Clinical Trials at the Summit.
An optimal injection technique is key to successful treatment, Glenn C. Yiu, MD, PhD, said.
Image: Adobe Stock
In the phase 3 PEACHTREE trial, suprachoroidal triamcinolone acetonide for uveitic macular edema (UME) showed sustained visual gains over 24 weeks and low rates of rescue after injections at day 0 and week 12. A real-world study based on IRIS Registry data found similar outcomes despite some differences in inclusion and exclusion criteria.
Seven hundred eighty-five patients were included, of which approximately 42% had glaucoma or ocular hypertension, “suggesting some provider confidence that this treatment can be given in patients with glaucoma and also aligns with the idea that steroid in the suprachoroidal space should not create a steroid-IOP response,” Yiu said.
Many of the patients had prior corticosteroid use, he said.
“When you look at the Kaplan-Meier curve, 87.7% of patients did not require rescue injection or implanted corticosteroids at week 24, which matches the performance in the PEACHTREE clinical trial, even though in the PEACHTREE trial, every patient had another injection given at week 12,” Yiu said.
Half of the rescue steroids were suprachoroidal triamcinolone, with the other half roughly divided between Ozurdex (dexamethasone intravitreal implant, AbbVie), sub-Tenon triamcinolone injection and intravitreal triamcinolone injection, he said. If all corticosteroids were included, the injection-free rate decreased to about 75%, suggesting that topical drops were used for rescue therapy in some cases.
Xipere (triamcinolone acetonide injectable suspension, Bausch + Lomb) is currently the only FDA-approved drug for UME. The needle for suprachoroidal injection comes in two lengths, 900 µm and 1,100 µm.
“In the clinical trials, 78% success on the first attempt could be achieved with the shorter needle in the superotemporal quadrant where the sclera is a little thinner,” Yiu said.
He concluded with pearls on the suprachoroidal injection technique.
“You have to hold the microinjector perpendicular to the sclera, you have to maintain firm contact to dimple, and you want to inject it slowly over 5 to 10 seconds,” he said.
Collapse
Yiu G. Suprachoroidal drug delivery in the real world. Presented at: Clinical Trials at the Summit; June 8, 2024; Park City, Utah.
Read more about
Click Here to Manage Email Alerts